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    v1.0.28
    OpenPayerBilling CodesOther forms of heart diseaseICD-10-CM i42-cardiomyopathy
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    ICD-10-CM Code For Cardiomyopathy: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group I42 includes diagnoses for cardiomyopathies such as dilated, hypertrophic, restrictive, and other specified forms of heart muscle disease that impair cardiac function. These ICD-10-CM diagnosis codes are used to document clinical scenarios including symptomatic heart failure, arrhythmias, and structural myocardial dysfunction, capturing disease severity and organ involvement. Accurate coding within the ICD-10-CM I42 group supports proper claim adjudication and appropriate reimbursement.

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    ICD-10-CM I42: Cardiomyopathy Overview

    The ICD-10-CM I42 group covers cardiomyopathies, a set of diseases affecting the heart muscle and its function. These diagnoses target the cardiovascular system and include dilated, hypertrophic, restrictive, and other specified cardiomyopathies that can lead to heart failure or arrhythmia. Accurate coding matters for reimbursement because it links clinical severity and complications to claims, supporting appropriate payment and clinical tracking.

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    When to Use

    Use a code from this group when a documented cardiomyopathy diagnosis is present, specifying the type when known and any associated heart failure or arrhythmia. Codes from this group are selected for clinical encounters involving evaluation, management, or treatment of myocardial disease and its complications.

    ICD-10-CM Codes

    10 rows

    ICD-10-CM CodeDescription
    I42.0Dilated cardiomyopathy
    I42.1Obstructive hypertrophic cardiomyopathy
    I42.2Other hypertrophic cardiomyopathy
    I42.3Endomyocardial (eosinophilic) disease
    I42.4Endocardial fibroelastosis
    I42.5Other restrictive cardiomyopathy
    I42.6Alcoholic cardiomyopathy
    I42.7Cardiomyopathy due to drug and external agent
    I42.8Other cardiomyopathies
    I42.9Cardiomyopathy, unspecified

    DRG Codes

    3 rows

    DRG CodeDescription
    314Other Circulatory System Diagnoses with MCC
    315Other Circulatory System Diagnoses with CC
    316Other Circulatory System Diagnoses without CC/MCC

    Typical Clinical Scenarios

    • An adult patient presents to the emergency department with acute onset severe dyspnea, hypotension, and signs of pulmonary edema after a recent viral prodrome. Echocardiography shows globally reduced left ventricular systolic function with dilation and an ejection fraction markedly decreased compared with prior studies; the clinician documents a new nonischemic dilated cardiomyopathy as the cause of acute heart failure, prompting admission for hemodynamic support and guideline-directed therapy. Typical codes: I42.0, I42.8
    • A middle-aged patient with long-standing hypertension and progressive exertional dyspnea is evaluated in outpatient cardiology; imaging demonstrates concentric left ventricular hypertrophy with impaired relaxation and preserved ejection fraction consistent with hypertrophic or restrictive changes secondary to chronic pressure overload. The working diagnosis is a chronic cardiomyopathy managed longitudinally with risk-factor control and surveillance for arrhythmia and heart failure progression. Typical codes: I42.2, I42.3
    • A patient with a history of cardiomyopathy presents for evaluation of new atrial fibrillation and thromboembolic stroke; chart review attributes the arrhythmia and embolic complication to underlying structural myocardial disease rather than ischemic coronary disease. The cardiomyopathy is coded as an important comorbidity contributing to the patient’s cardiac rhythm disorder and stroke risk. Typical codes: I42.7, I42.9

    Related Codes

    I30-ACUTE-PERICARDITIS

    ICD-10-CM Code For Acute Pericarditis: Group Overview

    I31-OTHER-DISEASES-OF-PERICARDIUM

    ICD-10-CM Code For Other Diseases Of Pericardium: Group Overview

    I32-PERICARDITIS-IN-DISEASES-CLASSIFIED-ELSEWHERE

    ICD-10-CM Code For Pericarditis In Diseases Classified Elsewhere: Group Overview

    I33-ACUTE-AND-SUBACUTE-ENDOCARDITIS

    ICD-10-CM Code For Acute And Subacute Endocarditis: Group Overview

    I34-NONRHEUMATIC-MITRAL-VALVE-DISORDERS

    ICD-10-CM Code For Nonrheumatic Mitral Valve Disorders: Group Overview

    I35-NONRHEUMATIC-AORTIC-VALVE-DISORDERS

    ICD-10-CM Code For Nonrheumatic Aortic Valve Disorders: Group Overview

    I36-NONRHEUMATIC-TRICUSPID-VALVE-DISORDERS

    ICD-10-CM Code For Nonrheumatic Tricuspid Valve Disorders: Group Overview

    I37-NONRHEUMATIC-PULMONARY-VALVE-DISORDERS

    ICD-10-CM Code For Nonrheumatic Pulmonary Valve Disorders: Group Overview

    I38-ENDOCARDITIS-VALVE-UNSPECIFIED

    ICD-10-CM Code For Endocarditis Valve Unspecified: Group Overview

    I39-ENDOCARDITIS-AND-HEART-VALVE-DISORDERS

    ICD-10-CM Code For Endocarditis And Heart Valve Disorders In Diseases Classified Elsewhere: Group Overview

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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